The purpose of this study is to compare two barrier membrane products, Cytoplast (dPTFE) and BioXclude (human amnion chorion allograft), for their relative efficacies in dental socket preservation procedures, both when the socket is filled and overfilled with freeze dried bone allograft (FDBA).
This single-blind, randomized clinical trial aims to compare two different, commercially available materials to assess their relative efficacies in socket preservation procedures after tooth extraction. Patients presenting with single teeth deemed clinically hopeless and treatment planned for removal in the normal course of clinical dentistry will be considered for this study. If eligible, a ridge/socket preservation procedure will be performed at the time of extraction. Periodontics residents will perform the procedure under the supervision of board certified staff. Patients will be randomized via concealed random number sequence into one of four groups, based on a combination of materials and graft placement techniques. Patients will be equally distributed into the following groups: (1) dense polytetrafluoroethylene (Cytoplast) (2) Cytoplast with additional buccal augmentation/onlay graft, (3) human amniotic-tissue derived membrane (BioXclude), and (4) BioXclude with additional buccal augmentation/onlay graft. All four treatment groups are consistent with the current standard of care, and this study seeks to compare techniques and materials as part of routine, clinical/periodontal therapy in order to determine superiority. Approximately 150 patients will be enrolled and distributed equally among the four groups. Any post-operative complications will be managed and documented during follow-up appointments at 1, 2 and 4 weeks. Cone beam computed tomography (CBCT) will be used as the primary assessment tool, and scans will be compared between a pre-operative baseline time point and a scan taken after 4 months of healing to prepare for implant placement. The primary dependent variables will be (1) percent of baseline alveolar ridge changes (both horizontal and vertical) and (2) whether or not the anticipated dental implant could be placed appropriately. Secondary outcomes include ease of use, perceptions of pain, complications, cost-effectiveness, and changes in keratinized tissue.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
150
ridge preservation intervention using the dPTFE membrane device
ridge preservation intervention using the dPTFE membrane device
ridge preservation intervention with additional freeze dried bone allograft (FDBA) placed buccal to the socket
Tingay Dental Clinic
Fort Gordon, Georgia, United States
Alveolar Ridge Width
Alveolar ridge dimensional change (horizontal) from Cone beam CT
Time frame: from baseline to final cone beam CT scan (approximately 4 months)
Alveolar Ridge Height
Alveolar ridge dimensional change (vertical) from cone beam CT
Time frame: from baseline to final cone beam CT scan (approximately 4 months)
Post-operative pain perception
self-report by patient on visual analog scale
Time frame: 1 week after surgical extraction procedure
Platform size of implant placed
Whether or not the originally intended implant size could be placed
Time frame: Implant surgery, approximtely 4 months after baseline
Keratinized tissue width (baseline)
Time frame: pre-op / baseline assessment (after randomization)(prior to time=0)
Keratinized tissue width (final)
Time frame: from pre-op assessment at time of randomization to implant surgery (4 months)
Elian classification (anticipated)
Operators will report an anticipated socket preservation classification according to Elian 2007
Time frame: pre-op / baseline assessment (after randomization)(prior to time=0)
Elian classification (actual)
Operators will report the actual socket preservation classification according to Elian 2007
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ridge preservation without overlay graft / traditional FDBA placement into the socket only
Time frame: intra-operative surgical finding (extraction surgery)(time=0)
Buccal plate thickness
intra-operative measurements, presence or absence of a dehiscence / fenestration
Time frame: intra-operative surgical finding (extraction surgery)(time = 0)
Buccal plate fenestration
determined at time of extraction surgery, and noted as a possible confounding variable
Time frame: intra-operative surgical finding (extraction surgery)(time = 0)
Complications after surgery (infection)
infection, determined by presence of purulence, lymphadenopathy and/or febrile status
Time frame: 0-4 months
Complications after surgery (membrane exfoliation)
dichotomous variable, presence or absence of the membrane for the duration of the study
Time frame: 0-4 months
Peri-operative clinician's report (extraction difficulty)
subjective extraction difficulty, as reported by the clinician
Time frame: intra-operative surgical finding (extraction surgery)